Rogers J N, Valley M A
Department of Anesthesiology, University of Texas Health Science Center at San Antonio.
Clin Podiatr Med Surg. 1994 Jan;11(1):73-83.
In summary, RSD is pain of neuropathic origin. The diagnosis is often obscure and requires a complete history, physical, and psychological evaluations. The diagnosis depends on symptoms (burning pain, allodynia and hyperpathia); signs (edema, sudomotor changes, temperature changes); and objective measurements, such as skin temperature, QSART, radiographs, and triple-phase bone scans; as well as the clinical response to a sympathetic block. Management of RSD should be designed to promote restoration of function utilizing physical therapy made possible by sympathetic, central, or peripheral nerve blockade. Medications may include nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, and vasoactive drugs. Psychologic support is an important part of the patient's rehabilitation. Dorsal column or peripheral nerve stimulators, sympathectomies, and narcotics should be considered only when other more conservative measures have failed.
总之，反射性交感神经营养不良（RSD）是一种神经性疼痛。其诊断往往不明确，需要完整的病史、体格检查及心理评估。诊断取决于症状（灼痛、痛觉过敏和感觉异常性疼痛）、体征（水肿、汗腺功能改变、温度变化）以及客观测量指标，如皮肤温度、定量汗腺轴突反射试验（QSART）、X线片和三相骨扫描，还有对交感神经阻滞的临床反应。RSD的治疗应旨在通过交感神经、中枢或周围神经阻滞实现物理治疗，从而促进功能恢复。药物治疗可包括非甾体类抗炎药、三环类抗抑郁药和血管活性药物。心理支持是患者康复的重要组成部分。仅当其他更保守的措施失败时，才应考虑使用脊髓后柱或周围神经刺激器、交感神经切除术和麻醉剂。
